Diagnosis of Strangulated Small Bowel Obstruction -Efficacy of Enhanced CT Scanning-

Masaya Mukai, Takashi Noto, Yoshio Iwata*, Masami Ikeda, Seiei Yasuda, Takashi Sugihara, Hiroyasu Makuuchi, Tetsuji Sasaki, Tomoo Tajima, Toshio Mitomi

Second Departments of Surgery and Diagnostic Radiology*, Tokai University School of Medicine

We have experienced 25 cases of strangulated small bowel obstruction with bowel resection in the past 10 years. According to the histological findings in the resected bowel, these cases were divided into a necrotic group and a non-necrotic group. Preoperative findings on the clinical course and hematobiochemical examination in these two groups were compared, but no significant examination in these two groups were compared, but no significant differences were found. The results of enhanced CT scanning in these two groups were analyzed and some characteristic findings were seen in the necrotic group. Gasless small bowel, disappearance of the Kerckring's folds and increased mesenteric density were special features in the necrotic cases. Blurred enhancement of the small bowel wall and increased density of the bowel contents indicating bleeding were observed in the more severe cases. Enhanced CT scanning is very useful for diagnosing strangulated small bowel obstruction and should be used in cases of suspected necrotic bowel.

Key words
ileus, enhanced computed tomography for small bowel obstruction, intestinal ischemia

Reprint requests
Masaya Mukai Second Department of Surgery, Tokai University School of Medicine
Bohseidai, Isehara, 259-11 JAPAN

Accepted
October 9, 1991

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